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Mayo Test ID SPSM Morphology Evaluation (Special Smear), Blood


Necessary Information


1. Include complete blood count results, if available, with the specimen.

2. Reason for testing should be included with the specimen.



Specimen Required


 


Useful For

Detecting disease states or syndromes of the white blood cells, red blood cells, or platelet cell lines of a patient's peripheral blood

Profile Information

Test ID Reporting Name Available Separately Always Performed
DIFFS Morphology Eval (Special Smear) No Yes
SPSM_ Special Smear No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
PINTP Peripheral Smear Interpretation No No
CBCN CBC without Differential Yes No

Testing Algorithm

If clinically abnormal results are identified by microscopic examination, a peripheral blood smear review is performed by a Hematopathologist at an additional charge.

 

If patient has not had a complete blood cell count in the last 3 days, one will be performed at an additional charge.

 

For more information see Acute Tickborne Disease Testing Algorithm.

Method Name

Manual-Microscopic Examination of Cells

Reporting Name

Morphology Eval (special smear)

Specimen Type

Whole blood

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole blood Ambient (preferred) CARTRIDGE
  Refrigerated  CARTRIDGE

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross icterus OK
Clotted Reject
 

Clinical Information

Under normal conditions, the morphology and proportion of each blood cell type is fairly consistent in corresponding age groups. The morphology and proportion of each blood cell type may change in various hematologic diseases. Differential leukocyte count and special smear evaluation are helpful in revealing the changes in morphology or proportion of each cell type in the peripheral blood.

Reference Values

Relative Values:

1-3 years

Neutrophils/bands: 22-51%

Lymphocytes: 37-73%

Monocytes: 2-11%

Eosinophils: 1-4%

Basophils: 0-2%

Metamyelocytes: 0%

Myelocytes: 0%

 

4-7 years

Neutrophils/bands: 30-65%

Lymphocytes: 29-65%

Monocytes: 2-11%

Eosinophils: 1-4%

Basophils: 0-2%

Metamyelocytes: 0%

Myelocytes: 0%

 

8-13 years

Neutrophils/bands: 35-70%

Lymphocytes: 23-53%

Monocytes: 2-11%

Eosinophils: 1-4%

Basophils: 0-2%

Metamyelocytes: 0%

Myelocytes: 0%

 

Adults

Neutrophils/bands: 50-75%

Lymphocytes: 18-42%

Monocytes: 2-11%

Eosinophils: 1-3%

Basophils: 0-2%

Metamyelocytes: <1%

Myelocytes: <0.5%

 

Absolute Values:

 

Absolute Neutrophils

Males:

0-14 days: 1.60-6.06 x 10(9)/L

15 days-4 weeks: 1.18-5.45 x 10(9)/L

5 weeks-7 weeks: 0.83-4.23 x 10(9)/L

8 weeks-5 months: 0.97-5.45 x 10(9)/L

6 months-23 months: 1.19-7.21 x 10(9)/L

24 months-35 months: 1.54-7.92 x 10(9)/L

3-5 years: 1.60-7.80 x 10(9)/L

6-16 years: 1.40-6.10 x 10(9)/L

17 years: 1.80-7.20 x 10(9)/L

Adults: 1.56-6.45 x 10(9)/L

 

Females:

0-14 days: 1.73-6.75 x 10(9)/L

15 days-4 weeks: 1.23-4.80 x 10(9)/L

5 weeks-7 weeks: 1.00-4.68 x 10(9)/L

8 weeks-5 months: 1.04-7.20 x 10(9)/L

6 months-23 months: 1.27-7.18 x 10(9)/L

24 months-35 months: 1.60-8.29 x 10(9)/L

3-5 years: 1.60-7.80 x 10(9)/L

6-14 years: 1.50-6.50 x 10(9)/L

15-17 years: 2.00-7.40 x 10(9)/L

Adults: 1.56-6.45 x 10(9)/L

 

Absolute Lymphocytes

Males:

0-14 days: 2.07-7.53 x 10(9)/L

15 days-4 weeks: 2.11-8.38 x 10(9)/L

5 weeks-7 weeks: 2.47-7.95 x 10(9)/L

8 weeks-5 months: 2.45-8.89 x 10(9)/L

6 months-23 months: 1.56-7.83 x 10(9)/L

24 months-35 months: 1.13-5.52 x 10(9)/L

3-5 years: 1.60-5.30 x 10(9)/L

6-11 years: 1.40-3.90 x 10(9)/L

12-17 years: 1.00-3.20 x 10(9)/L

Adults: 0.95-3.07 x 10(9)/L

 

Females:

0-14 days: 1.75-8.00 x 10(9)/L

15 days-4 weeks: 2.42-8.20 x 10(9)/L

5 weeks-7 weeks: 2.29-9.14 x 10(9)/L

8 weeks-5 months: 2.14-8.99 x 10(9)/L

6 months-23 months: 1.52-8.09 x 10(9)/L

24 months-35 months: 1.25-5.77 x 10(9)/L

3-5 years: 1.60-5.30 x 10(9)/L

6-11 years: 1.40-3.90 x 10(9)/L

12-17 years: 1.00-3.20 x 10(9)/L

Adults: 0.95-3.07 x 10(9)/L

 

Absolute Monocytes

Males:

0-14 days: 0.52-1.77 x 10(9)/L

15 days-4 weeks: 0.28-1.38 x 10(9)/L

5 weeks-7 weeks: 0.28-1.05 x 10(9)/L

8 weeks-5 months: 0.28-1.07 x 10(9)/L

6 months-23 months: 0.25-1.15 x 10(9)/L

24 months-35 months: 0.19-0.94 x 10(9)/L

3-5 years: 0.30-0.90 x 10(9)/L

6-17 years: 0.20-0.80 x 10(9)/L

Adults: 0.26-0.81 x 10(9)/L

 

Females:

0-14 days: 0.57-1.72 x 10(9)/L

15 days-4 weeks: 0.42-1.21 x 10(9)/L

5 weeks-7 weeks: 0.28-1.21 x 10(9)/L

8 weeks-5 months: 0.24-1.17 x 10(9)/L

6 months-23 months: 0.26-1.08 x 10(9)/L

24 months-35 months: 0.24-0.92 x 10(9)/L

3-5 years: 0.30-0.90 x 10(9)/L

6-17 years: 0.20-0.80 x 10(9)/L

Adults: 0.26-0.81 x 10(9)/L

 

Absolute Eosinophils

Males:

0-14 days: 0.12-0.66 x 10(9)/L

15 days-4 weeks: 0.08-0.80 x 10(9)/L

5 weeks-7 weeks: 0.05-0.57 x 10(9)/L

8 weeks-5 months: 0.03-0.61 x 10(9)/L

6 months-23 months: 0.02-0.82 x 10(9)/L

24 months-35 months: 0.03-0.53 x 10(9)/L

3-11 years: 0.00-0.50 x 10(9)/L

12-17 years: 0.10-0.20 x 10(9)/L

Adults: 0.03-0.48 x 10(9)/L

 

Females:

0-14 days: 0.09-0.64 x 10(9)/L

15 days-4 weeks: 0.06-0.75 x 10(9)/L

5 weeks-7 weeks: 0.04-0.63 x 10(9)/L

8 weeks-5 months: 0.02-0.74 x 10(9)/L

6 months-23 months: 0.02-0.58 x 10(9)/L

24 months-35 months: 0.03-0.46 x 10(9)/L

3-11 years: 0.00-0.50 x 10(9)/L

12-17 years: 0.10-0.20 x 10(9)/L

Adults: 0.03-0.48 x 10(9)/L

 

Absolute Basophils

Males:

0-14 days: 0.02-0.11 x 10(9)/L

15 days-7 weeks: 0.01-0.07 x 10(9)/L

8 weeks-35 months: 0.01-0.06 x 10(9)/L

3-17 years: 0.00-0.10 x 10(9)/L

Adults: 0.01-0.08 x 10(9)/L

 

Females:

0-14 days: 0.02-0.07 x 10(9)/L

15 days-4 weeks: 0.01-0.06 x 10(9)/L

5 weeks-7 weeks: 0.01-0.05 x 10(9)/L

8 weeks-5 months: 0.01-0.07 x 10(9)/L

6 months-35 months: 0.01-0.06 x 10(9)/L

3-17 years: 0.00-0.10 x 10(9)/L

Adults: 0.01-0.08 x 10(9)/L

 

An interpretive report will be provided.

Interpretation

The laboratory will provide an interpretive report of percentage of white blood cells and, if appropriate, evaluation of white blood cells, red blood cells, and platelets.

Cautions

No significant cautionary statements

Clinical Reference

1. Kjeldsberg CR, eds. Practical Diagnosis of Hematologic Disorders. 5th ed. American Society of Clinical Pathologists; 2010

2. Weinberg SE, Behdad A, Ji P. Atypical lymphocytes in peripheral blood of patients with COVID-19. Br J Haematol. 2020;190(1):36-39

3. Pozdnyakova O, Connell NT, Battinelli EM, Connors JM, Fell G, Kim AS. Clinical significance of CBC and WBC morphology in the diagnosis and clinical course of COVID-19 infection. Am J Clin Pathol. 2021;155(3):364-375. doi:10.1093/ajcp/aqaa231

Method Description

Microscopic examination of a Wright-Giemsa-stained smear.(Unpublished Mayo method)

Day(s) Performed

Monday through Sunday

Report Available

1 to 2 days

Specimen Retention Time

Slides: 1 year

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

85007

85060-(if appropriate)

85027-(if appropriate)

88184-(If appropriate)

88185-(If appropriate)

88187-(if appropriate)

88188-(if appropriate)

88189-(if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SPSM Morphology Eval (special smear) 14869-2

 

Result ID Test Result Name Result LOINC Value
SEGBA Neutrophilic Segs and Bands 23761-0
LYMPH Lymphocytes 26478-8
MONOC Monocytes 26485-3
EOS Eosinophils 714-6
BASO Basophils 707-0
META Metamyelocytes 740-1
MYEL Myelocytes 749-2
PROMY Promyelocytes 783-1
UBLS Blasts 709-6
PLSM Plasma Cells 79426-3
M_KR Megakaryocytes 19252-6
NUCL Nucleated RBC 19048-8
FRAGC Fragile Cells In Process
BL_PR Blasts and Promonocytes In Process
MANC Absolute Neutrophil 753-4
INT01 Interpretation 59466-3
REV96 Reviewed by: 18771-6

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.